Blood Drive
Please only fill out this form if you are definite about donating or are still in the consideration process.
*Form can only be submitted once, so we will follow up with you if you are still in the process of deciding*

In advance, I would like to thank everyone for their consideration in donating blood. This is a big decision and can do a lot of good in the world. If you decide to donate you can save 3 lives through just one donation.

Many thanks,
Student Government and the Blood Drive Committee
Questions? Email: gramur1@nilesk12.org
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Email *
Name *
 (School) Email Address *
Homeroom teacher and the room number of your homeroom
Age as of 10/31/2019 (if staff please select "staff") *
I am... *
Free Periods (Please select all that you will be available on 10/31/2019) *Must have at least 1 free period to donate* *
Required
Why do you choose to donate blood? Optional: Will be posted (Your name will not be used unless you write your name at the end)
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